Signaling Pathways in Endometrial Cancer Cells

A special issue of Cells (ISSN 2073-4409). This special issue belongs to the section "Cell Signaling".

Deadline for manuscript submissions: 20 January 2026 | Viewed by 7886

Special Issue Editor


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Guest Editor
Department of Obstetrics and Gynecology, The University of Tokyo Hospital, Tokyo, Japan
Interests: endometrial cancer; ovarian cancer; molecular-targeted therapy; cellular signaling; bone morphogenic proteins

Special Issue Information

Dear Colleagues,

Endometrial cancer (EC) develops from the uterine endometrial epithelium. Recent reports indicate that oncogenic mutations are already present in normal endometrium, suggesting that altered signaling pathways are involved in carcinogenesis. The PI3K/AKT/mTOR pathway is the most frequent activated signaling pathway in EC cells. This pathway governs cell proliferation, metabolism, and DNA damage repair. The RAS/MAPK pathway is also important for EC cell growth. However, inhibitors for both signaling pathways have not been successful in clinical trials. Historically, EC has been classified into two types according to hormone dependence. ER, PgR-positive, hormone-dependent ECs are sensitive to progesterone and aromatase inhibitors that partially block both the PI3K/AKT/mTOR and RAS/MAPK pathways. Recently, four molecular classifications have been proposed according to the TCGA project. POLE ultramutated and MSI subtypes are susceptible to immune checkpoint inhibitors. In contrast, the other two subtypes are resistant to immunotherapy. Interestingly, CDK4/6 and Wee1 inhibitors are effective for CN-L and CN-H subtypes, respectively. These findings indicate that modification of various signaling pathways may be useful in the treatment of EC.

Under this perspective, this Special Issue aims to describe the current advances in basic and translational research that focus on “Signaling Pathways in Endometrial Cancer Cells”.

Dr. Tomohiko Fukuda
Guest Editor

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Keywords

  • endometrial cancer
  • cellular signaling
  • cell metabolism
  • DNA damage repair pathway
  • the PI3K/AKT/mTOR pathway
  • the RAS/MAPK pathway
  • molecular classification

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Published Papers (4 papers)

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Review

27 pages, 1202 KB  
Review
Integrating Multi-Omics in Endometrial Cancer: From Molecular Insights to Clinical Applications
by Hye Kyeong Kim and Taejin Kim
Cells 2025, 14(17), 1404; https://doi.org/10.3390/cells14171404 - 8 Sep 2025
Viewed by 606
Abstract
Endometrial cancer (EC) is the most common gynecologic malignancy in developed countries, and its incidence is increasing globally. While early-stage ECs generally show good prognosis, advanced or recurrent cases and those with aggressive histologic subtypes exhibit poor outcomes. Traditional histopathologic classification, however, fails [...] Read more.
Endometrial cancer (EC) is the most common gynecologic malignancy in developed countries, and its incidence is increasing globally. While early-stage ECs generally show good prognosis, advanced or recurrent cases and those with aggressive histologic subtypes exhibit poor outcomes. Traditional histopathologic classification, however, fails to reflect the molecular heterogeneity of EC, limiting its role in guiding treatment. Recent developments in multi-omics have enhanced our understanding of EC biology, which supports more personalized treatment strategies. The Cancer Genome Atlas (TCGA) classification has provided a more systematic molecular framework for stratifying risk and identifying prognostic and therapeutic biomarkers. This review discusses the latest developments in multi-omics-based classification of EC, highlights emerging diagnostic and therapeutic strategies, and summarizes ongoing clinical trials that aim to translate molecular discoveries into improved outcomes. Full article
(This article belongs to the Special Issue Signaling Pathways in Endometrial Cancer Cells)
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20 pages, 744 KB  
Review
HER2/neu as a Signaling and Therapeutic Marker in Uterine Serous Carcinoma
by Victoria M. Ettorre, Luca Palmieri, Valentino Clemente and Alessandro D. Santin
Cells 2025, 14(16), 1282; https://doi.org/10.3390/cells14161282 - 19 Aug 2025
Viewed by 1068
Abstract
Research into aggressive gynecologic cancers such as uterine serous carcinoma (USC) has recently evolved from chemotherapy to the development of drugs targeting specific biomarkers differentially expressed/active in tumor cells. One such target is HER2/neu, which plays an important role in the coordination of [...] Read more.
Research into aggressive gynecologic cancers such as uterine serous carcinoma (USC) has recently evolved from chemotherapy to the development of drugs targeting specific biomarkers differentially expressed/active in tumor cells. One such target is HER2/neu, which plays an important role in the coordination of cell growth and differentiation. Importantly, when overexpressed and/or amplified in tumor cells, the downstream tyrosine kinase of HER2/neu becomes constitutively activated, causing dysregulated gene transcription. In breast cancer patients, HER2/neu has been successfully utilized for many years as a target for multiple monoclonal antibodies and more recently antibody–drug conjugates (ADCs). Use in gynecologic malignancies has been slower, however, due to recently identified unique characteristics of HER2/neu protein expression and gene amplification in biologically aggressive tumors such as USC including its major heterogeneity and lack of apical staining when compared to breast cancer. Accordingly, the use of optimal testing algorithms for HER2/neu status in patients with USC may have important implications for the development of novel, effective, and targeted treatment modalities against this lethal variant of endometrial cancer. In this review, we discuss HER2/neu gene expression in USC, evaluate the efficacy of HER2/neu-directed therapies in both preclinical and clinical settings, and discuss possible mechanisms of resistance to HER2/neu targeting agents. Full article
(This article belongs to the Special Issue Signaling Pathways in Endometrial Cancer Cells)
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18 pages, 944 KB  
Review
The Importance of Cancer Stem Cells and Their Pathways in Endometrial Cancer: A Narrative Review
by Laura Georgiana Caravia, Melinda Ildiko Mitranovici, Ioan Emilian Oala, Andreea Taisia Tiron, Anca Angela Simionescu, Alina Maria Borcan and Marius Craina
Cells 2025, 14(8), 594; https://doi.org/10.3390/cells14080594 - 14 Apr 2025
Cited by 1 | Viewed by 1398
Abstract
Endometrial cancer is one of the most common malignancies seen in women in developed countries. While patients in the early stages of this cancer show better responses to surgery, adjuvant hormonal therapy, and chemotherapy, patients with recurrence show treatment resistance. Researchers have recently [...] Read more.
Endometrial cancer is one of the most common malignancies seen in women in developed countries. While patients in the early stages of this cancer show better responses to surgery, adjuvant hormonal therapy, and chemotherapy, patients with recurrence show treatment resistance. Researchers have recently focused on cancer stem cells (CSCs) in the treatment of gynecologic cancer in general but also specifically in endometrial cancer. CSCs have been investigated because of their resistance to conventional therapies, such as chemo- and radiotherapy, and their ability to induce the progression and recurrence of malignancy. The activation of alternative pathways, such as WNT, PI3K, NF-kB, or NOTCH, could be the basis of the acquisition of these abilities of CSCs. Their specific markers and signaling pathways could be treatment targets for CSCs. In this article, we discuss the importance of obtaining a better understanding of the molecular basis and pathways of CSCs in endometrial cancer and the role of CSCs, aiming to discover more specific therapeutic approaches. Full article
(This article belongs to the Special Issue Signaling Pathways in Endometrial Cancer Cells)
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21 pages, 3144 KB  
Review
Development of Antibody–Drug Conjugates for Malignancies of the Uterine Corpus: A Review
by Taro Yamanaka, Tadaaki Nishikawa and Hiroshi Yoshida
Cells 2025, 14(5), 333; https://doi.org/10.3390/cells14050333 - 24 Feb 2025
Viewed by 4059
Abstract
Despite recent advances in cancer treatment, the prognosis for uterine malignancies (carcinoma and sarcoma) requires further improvement. Antibody–drug conjugates (ADCs) have emerged as a novel class of anti-cancer therapeutic agents, and multiple ADCs have been approved for other types of cancer. In 2024, [...] Read more.
Despite recent advances in cancer treatment, the prognosis for uterine malignancies (carcinoma and sarcoma) requires further improvement. Antibody–drug conjugates (ADCs) have emerged as a novel class of anti-cancer therapeutic agents, and multiple ADCs have been approved for other types of cancer. In 2024, trastuzumab deruxtecan received approval from the US Food and Drug Administration for cancer types and became the first ADC approved for the treatment of uterine malignancies. Many ADCs are currently being investigated in uterine malignancies, and therefore, there is a need to gain a deeper understanding of ADCs. In this article, we aim to provide a comprehensive overview of the advancements in ADCs. The contents of this article include the structure and mechanism of action, an analysis of recent clinical trials, and expected future clinical questions. This article also focuses on uterine sarcoma, which is not often highlighted as a target for ADC treatment. Full article
(This article belongs to the Special Issue Signaling Pathways in Endometrial Cancer Cells)
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